【摘要】 目的：探讨组织运动二尖瓣环位移（TMAD）技术纵向评估正常双绒毛膜双胎妊娠孕妇中孕期、分娩前、分娩后左心室收缩功能的应用价值。方法：选取正常双绒毛膜双胎妊娠孕妇32例，分别于中孕期、分娩前和分娩后（产后1周）进行超声心动图检查。首先获得左心室收缩功能及舒张功能的常规参数，再留存心尖四腔心、两腔心动态图像，应用QLab13.0分析软件中的TMAD技术获得心尖四腔心切面二尖瓣环室间隔位点位移、侧壁位点位移、二尖瓣环平均位移、二尖瓣环平均位移率，心尖两腔心切面二尖瓣环下壁位点位移、前壁位点位移、二尖瓣环平均位移、二尖瓣环平均位移率。对三个时期评估左心室收缩功能相关参数进行分析比较。结果：(1)与中孕期比较，产前及产后LVDD、LVDS、EDV、ESV、SV均升高，差异有统计学意义（P<0.05）。(2)与中孕期比较，分娩前E峰、E/A降低，A峰升高，IVRT延长，差异有统计学意义（P<0.05）；分娩后E峰、E/A降低，IVRT延长，差异有统计学意义（P<0.05）。(3)分娩前TMAD各参数较中孕期降低（均P<0.05）；分娩后TMAD各参数较分娩前降低（均P<0.05），差异均有统计学意义。结论：TMAD相关参数在早期、敏感定量评估双绒毛膜双胎孕妇中孕期及分娩前、后母体左心室收缩功能改变中具有一定的应用价值，且随孕周增加至分娩前、后母体心脏舒张功能出现受损。更多还原

【Abstract】 Objective: To explore the application value of tissue motion mitral annular displacement(TMAD) technique of the mitral valve in longitudinal evaluation of left ventricular systolic function in pregnant women with normal dichorionic twin pregnancy mid-pregnancy, before delivery and after delivery. Methods: Thirty-two pregnant women with normal dichorionic twin pregnancy were selected. Echocardiography was performed during the second trimester, before delivery and after delivery(1week after delivery). First, the conventional parameters of left ventricular systolic function and diastolic function were obtained,and then the apical four-chamber and two-chamber dynamic images were retained. The interventricular septal displacement,lateral wall displacement, mean mitral annular displacement and mean mitral annular displacement rate of apical four-chamber view, and the inferior wall displacement, anterior wall displacement, mean mitral annular displacement and mean mitral annular displacement rate of apical two-chamber view were obtained by TMAD technique in QLab13.0 analysis software. The parameters related to the assessment of left ventricular systolic function in three periods were analyzed and compared. Results:(1)Compared with the second trimester, LVDD, LVDS, EDV, ESV and SV increased before and after delivery(P<0.05).(2)Compared with the second trimester, E peak and E/A decreased, A peak increased, and IVRT prolonged before delivery(P<0.05);E peak and E/A decreased, IVRT prolonged after delivery(P<0.05).(3)The parameters of TMAD before delivery were lower than those in the second trimester(all P<0.05). The TMAD parameters after delivery were lower than those before delivery(all P<0.05). Conclusion: TMAD related parameters have certain application value in early and sensitive quantitative evaluation of left ventricular systolic function changes in pregnant women with dichorionic twins during pregnancy and peripartum. And with the increase of gestational age, the maternal cardiac diastolic function was impaired before and after delivery.更多还原